The Evaluation of Carotid Intima Thickness in Clinical and Subclinical Hypothyroidism and Effects of Thyroid Hormone Treatment
American Journal of Clinical and Experimental Medicine
Volume 2, Issue 4, July 2014, Pages: 59-63
Received: Apr. 25, 2014;
Accepted: Jun. 17, 2014;
Published: Jun. 30, 2014
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Ayşe Neslin Akkoca, Mustafa Kemal University Medical School, Department of Family Medicine, Hatay, Turkey
Zeynep Tuğba Özdemir, Bozok University Medical School, Department of Internal Medicine,Yozgat,Turkey
Gül Soylu Özler, Mustafa Kemal University Medical School, Otorhinolaryngology Department,Hatay,Turkey
Laika Karabulut, Gastroenterology Specialist, Okmeydanı Research and TrainingHospital, Istanbul, Turkey
Objectives: In this study, our aim was to investigate the CA-IMT in clinical hypothyroidism(CH) and subclinical hypothyroidism(SCH) and the effects of L-thyroxine replacement. Materials and methods: The study group consisted of 20 patients with clinical hypothyroidism(CH group) and 20 patients with subclinical hypothyroidism(SCH group) and 20 patients with with normal thyroid hormone function tests (control group). Serum TSH, fasting glucose, lipid profile(total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride),HbA1c,insulin,HOMA and carotid intima media thickness(CA-IMT) of all subjects were measured at admission. Thereafter, all hypothyroid patients received L- thyroxine treatment. The previous tests were re-examined after achievement of euthyroidism for 6 months. The results of the tests before and after L- thyroxine treatment were compared. Results: The levels of TSH, total cholesterol, triglyceride, LDL for CH and SCH group were statistically different before and after treatment(p≤ 0.05). The levels of glucose, HDL,VLDL, HbA1c, insulin and HOMA for CH and SCH group were similar before and after treatment(p≥ 0.05). The difference of CA-IMT for both sides before and after treatment was statistically significant(p ≤0.05). Conclusion: This study suggests that subjects with clinical and subclinical hypothyroidism are characterized by an increment in the CA-IMT resulting from an adverse lipid profile, which can be reversed by thyroid hormone replacement. So, thyroid hormone replacement may be helpful to prevent or at least slow down atherosclerosis in hypothyroid subjects.
Ayşe Neslin Akkoca,
Zeynep Tuğba Özdemir,
Gül Soylu Özler,
The Evaluation of Carotid Intima Thickness in Clinical and Subclinical Hypothyroidism and Effects of Thyroid Hormone Treatment, American Journal of Clinical and Experimental Medicine.
Vol. 2, No. 4,
2014, pp. 59-63.
O’Leary DH,Polak JF. Intima-media thickness: a tool for atherosclerosis imaging and event predic-tion. American Journal of Cardiology 2002;90:18-21.
Baldassarre D, Tremoli E, Amato M, Veglia F, Bondioli A,Sirtori CR. Reproducibility validation study comparing analog and digital im-aging technologies for the measurement of intima-media thickness. Stroke 2000;31: 1104–1110.
P. M. Ridker PM, M. J. Stampfer MJ, and N. Rifai N.Novel risk factors for sys-temic atherosclerosis: a comparison of Creactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA 2001;285: 2481–2485.
Razvi S, Shakoor A, Vanderpump M, Weaver JU, Pearce SH. The influence of age on the relationship between subclinical hypothyroidism and ischemic heart disease: a metaanalysis. J Clin Endocrinol Metab2008;93: 2998-3007.
Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study.Ann Intern Med 2000;132: 270-278.
Walsh JP, Bremner AP, Bulsara MK, O’Leary P, Leedman PJ, Feddema P, Michelangeli V. Subclinical thyroid dysfunction as a risk factor for cardiovascular dis-ease. Arch Intern Med 2005;165: 2467-2472.
Kuller LH, Burke GL, Tracy RP, Ladenson PW. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA 2006;295: 1033-1041.
Rodondi N, Newman AB, Vittinghoff E, de Rekeneire N, Satterfield S, Harris TB, Bauer DC. Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death. Arch Intern Med 2005;165: 2460-2466.
Chiche F, Jublanc C, Coudert M, Car-reau V, Kahn JF, Bruckert E. Hypothyroidism is not associated with increased carotid atherosclero-sis when cardiovascular risk factors are accounted for in hyperlipidemic patients. Atherosclerosis 2008;203: 269-276.
Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation1997; 96: 1432-1437.
Nagasaki T, Inaba M, Henmi Y, Kumeda Y, Ueda M, Taha-ra H, Sugiguchi S, Fujiwara S, Emoto M, Ishimura E, Onoda N, Ishikawa T, Nishizawa Y. Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function. Clin Endocrinol (Oxf)2003; 59: 607-612.
Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, Ferrannini E, Salvetti A, Monzani F. Low-grade systemic inflammation causes en-dothelial dysfunction in patients with Hashimoto’ s thyroiditis. J Clin Endocrinol Metab 2006;91: 5076-5082.
Kvetny J, Heldgaard PE, Bladbjerg EM, Gram J. Subclinical hypothyroidism is associated with a lowgrade inflammation, increased triglyceride levels and predicts cardiovascu-lar disease in males below 50 years. Clin Endocrinol (Oxf)2004; 61: 232-238.
Xiang GD, He YS, Zhao LS, Hou J, Yue L, Xiang HJ. Impairment of endothelium-dependent arterial dilation in Hashimoto’s thyroiditis patients with euthyroidism. Clin Endocrinol (Oxf) 2006;64: 698-702.